Expert opinion on the metabolic complications of new anticancer therapies: Tyrosine kinase inhibitors.
Fiche publication
Date publication
août 2018
Journal
Annales d'endocrinologie
Auteurs
Membres identifiés du Cancéropôle Est :
Pr VERGES Bruno
Tous les auteurs :
Buffier P, Bouillet B, Smati S, Archambeaud F, Cariou B, Verges B
Lien Pubmed
Résumé
Tyrosine kinase inhibitors (TKI) interfere with glucose metabolism. Contrasting effects have been reported, even for a given molecule. Hyperglycemia rates range between 15 and 40%; nilotinib seems to be the molecule most liable to induce diabetes. Metabolic effects range from metabolic syndrome to onset of diabetes, requiring treatment based on insulin resistance, although pathophysiology is unclear. It is noteworthy that fulminant diabetes has never been reported under TKIs. TKIs may lead to hypoglycemia in type 1 or 2 diabetes. Several cases have been reported of improvement in glycemia and in HbA1c, with reduction or even termination of insulin therapy, mainly under imatinib and sunitinib. Fasting glucose levels should be checked before, during and after treatment, plus HbA1C in diabetic patients, with reinforced self-monitoring. These side-effects are transient and never contraindicate continuation of TKIs. Dyslipidemia under TKI has been reported, concerning both LDL-cholesterol and triglycerides. Although variations seem to be slight, lipid assessment is recommended before, during and after treatment.
Mots clés
Diabetes, Diabète, Dyslipidemia, Dyslipidémie, Inhibiteurs Tyrosine kinase, Tyrosine kinase inhibitors
Référence
Ann. Endocrinol. (Paris). 2018 Aug 1;: